Rachel Patzer, PhD, MPH Associate Professor Director, Health Services Research Center Department of Medicine Department of Surgery Emory University School of Medicine

Disparities Persist Between Kidney Transplantation and Dialysis Facility Ownership

MedicalResearch.com Interview with:

Rachel Patzer, PhD, MPH Associate Professor Director, Health Services Research Center Department of Medicine Department of Surgery Emory University School of Medicine

Dr. Patzer

Rachel Patzer, PhD, MPH
Associate Professor
Director, Health Services Research Center
Department of Medicine
Department of Surgery
Emory University School of Medicine

 

MedicalResearch.com: What is the background for this study?

Response: We know that historically, for-profit dialysis facilities have been shown to have lower rates of kidney transplantation than patients who receive treatment in non-profit dialysis facilities. However, these studies are outdated, and did not examine access to living donor transplantation or include the entirety of the end-stage kidney disease population 

MedicalResearch.com: What are the main findings?

Response: .  The main findings of our study are that over the 17-year study period, there was a consistent disparity by dialysis facility ownership with respect to access to the national waiting list, as well as deceased and living donor transplantation.

MedicalResearch.com: What should readers take away from your report?

Response: Despite studies that called attention to this issue several decades ago, it does not appear as though there has been any improvements in access to kidney transplantation among patients who receive dialysis in for-profit dialysis facilities. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: We cannot say for certain whether the disparities we see are due to leadership or provider practices within the for-profit dialysis facilities and whether these facilities are educating or referring fewer patients for transplant, because these data are not available in national surveillance data.  Our research team is working to collect better day on these endpoints to study earlier steps in the transplant process. 

MedicalResearch.com: Is there anything else you would like to add? 

Response: It is important for patients with late-stage chronic kidney disease or those who are starting on dialysis to have conversations about kidney transplant as a treatment option with their clinical providers, such as their nephrologist or social worker. The providers in dialysis facilities – regardless of profit status – are required by law to educate patients about transplant as a treatment option. Ideally this should include a thorough discussion with a chance for patients to ask questions about the risks and benefits of treatment options, and the steps necessary to get a kidney transplant. If this does not occur, patients should advocate for themselves and ask questions about their potential candidacy for transplant.   

Citation:

Gander JC, Zhang X, Ross K, et al. Association Between Dialysis Facility Ownership and Access to Kidney Transplantation. JAMA. 2019;322(10):957–973. doi:10.1001/jama.2019.12803

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Last Modified: Sep 11, 2019 @ 1:17 pm 

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